Hecht H, van Calker D, Berger M, von Zerssen D
Department of Psychiatry and Psychotherapy, University Hospital of Freiburg, Germany.
J Affect Disord. 1998 Oct;51(1):33-43. doi: 10.1016/s0165-0327(98)00154-2.
In studies of both patients and high-risk subjects, particular patterns of personality have been found to be associated with affective disorders. Neuroticism and features of the melancholic type of personality seem to be risk factors for depression while premorbid features of the manic type of personality predominate in patients with more manic than depressive episodes. While neuroticism prevails in the majority of mental disorders, the 'affective' personality variants appear to be more specifically associated with affective disorders.
Personality features were investigated in 122 recovered patients with affective disorders, 58 first-degree relatives (high-risk subjects (HR)) and in the respective control groups (n=48; n=29). Patients were subdivided into: unipolar depression (melancholic subtype); bipolar II; bipolar I with more depressive episodes and bipolar I with more manic episodes. Personality measures were based on the Biographical Personality Interview (BPI) and the Munich Personality Test (MPT).
The melancholic personality type (BPI) decreased from the unipolar depressives to the mainly manic group, while features of the manic type increased. MPT scores failed to discriminate between subgroups of patients. HR were significantly more introverted and had a stronger orientation towards social norms than controls according to the MPT, and showed a tendency towards the melancholic type according to the BPI.
The sizes of some groups or subgroups are relatively small. Therefore, they have to be enlarged in the continuation of the study so as to increase the power of the statistical tests and thus to ascertain the robustness of the results.
Features of the typus melancholicus seem to be a risk factor for depression. The identification of highly predictive risk factors provides an opportunity for the development of prevention programs.
在针对患者和高危人群的研究中，已发现特定的人格模式与情感障碍有关。神经质以及抑郁型人格特征似乎是抑郁症的危险因素，而躁狂型人格的病前特征在躁狂发作多于抑郁发作的患者中更为常见。虽然神经质在大多数精神障碍中普遍存在，但“情感性”人格变体似乎与情感障碍更具特异性关联。
对122名康复的情感障碍患者、58名一级亲属（高危人群（HR））以及各自的对照组（n = 48；n = 29）进行了人格特征调查。患者被分为：单相抑郁症（抑郁亚型）；双相II型；抑郁发作较多的双相I型和躁狂发作较多的双相I型。人格测量基于传记式人格访谈（BPI）和慕尼黑人格测试（MPT）。
抑郁型人格类型（BPI）从单相抑郁症患者到主要为躁狂发作的组逐渐减少，而躁狂型特征则增加。MPT分数未能区分患者亚组。根据MPT，高危人群比对照组明显更内向，对社会规范的取向更强，根据BPI则显示出倾向于抑郁型的趋势。
一些组或亚组的规模相对较小。因此，在后续研究中必须扩大样本量，以提高统计检验的效力，从而确定结果的稳健性。
抑郁型特征似乎是抑郁症的危险因素。识别高度预测性的危险因素为制定预防方案提供了机会。
